Intended for healthcare professionals

Head To Head Head to Head

Would judicial consent for assisted dying protect vulnerable people?

BMJ 2015; 351 doi: (Published 19 August 2015) Cite this as: BMJ 2015;351:h4437
  1. Jacky Davis, consultant radiologist, Whittington Hospital, London, chair of Healthcare Professionals for Assisted Dying, and member of BMA Council and BMA Medical Ethics Committee,
  2. Ilora Finlay, professor of palliative medicine, Cardiff University, co-chair of Living and Dying Well, chair elect of National Council for Palliative Care, immediate past president of BMA, and member of BMA Medical Ethics Committee
  1. Correspondence to: J Davis drjcdavis{at}, I Finlay FINLAYI{at}

The private members’ bills presented by Charles Falconer and Rob Marris require a High Court judge to confirm decisions by doctors to approve assisted suicide. Jacky Davis thinks that this is sufficient to protect vulnerable people; Ilora Finlay does not

Yes—Jacky Davis

Next month the United Kingdom’s MPs will debate the Assisted Dying Bill championed by the Labour MP Rob Marris.1 It is based on Charles Falconer’s bill that made unprecedented progress through the House of Lords, only to run out of time before the general election.

The Marris-Falconer bill would offer the possibility of an assisted death for terminally ill, mentally competent adults. After meeting strict legal safeguards (including the involvement of a High Court judge) such people would be able to self administer life ending drugs. The bill is based on legislation in the US state of Oregon that has operated safely since 1997. Similar legislation has since been adopted by the states of Washington and Vermont and is being considered by several others.

Slippery slope

One concern among opponents of assisted dying is the “slippery slope,” whereby the law could be extended to include, or could disproportionately involve, vulnerable people—including people with disability, older people, or those who lack the capacity to make an informed decision. But no such abuse or extension of the law has occurred in Oregon, where assisted deaths account for about 0.3% of all deaths.2 Research shows that potentially vulnerable groups are actually under-represented in figures showing people who have chosen an assisted death.3 Nor, importantly, has there been any evidence of coercion. Nevertheless, to meet the concerns of those who oppose a change in the UK law, the House of Lords introduced the additional safeguard of judicial oversight.

Under the proposed legislation, patients themselves make the request for assisted dying. Patients and their …

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